Active NPI
Mary -Kay Annuzzi, DMD
- Pediatric Dentistry
- Sicklerville, NJ
National Provider Identifier
1871622787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DI 02215
- Practice address
- 1304 Liberty PL
Sicklerville, NJ 08081-5710 - Phone
- (856) 875-9550
- Fax
- (856) 875-0180
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DI 02215 | NJ | Primary |
Addresses
Primary practice location
1304 Liberty PL
Sicklerville, NJ 08081-5710
Mailing address
533 Judy Ave
Franklinville, NJ 08322-3912
Phone (856) 582-1000
Other practice location 1
1630 Route 322
Woolwich Twp, NJ 08085-3701
Phone (856) 875-9550
Other practice location 2
2055 Briggs Rd
Mount Laurel, NJ 08054-4630
Phone (856) 875-9550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 6, 2016 through Jun 6, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI 02215 | NJ | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington TWP Dental Assoc, P.a. | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Sewell, NJ
- NPI 1730305640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631059200000",
"number": "1871622787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "533 JUDY AVE",
"city": "FRANKLINVILLE",
"state": "NJ",
"postal_code": "083223912",
"telephone_number": "856-582-1000",
"fax_number": "856-589-1093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 LIBERTY PL",
"city": "SICKLERVILLE",
"state": "NJ",
"postal_code": "080815710",
"telephone_number": "856-875-9550",
"fax_number": "856-875-0180"
}
],
"practiceLocations": [
{
"address_1": "1630 Route 322",
"address_purpose": "LOCATION",
"city": "Woolwich Twp",
"state": "NJ",
"postal_code": "080853701",
"country_code": "US",
"telephone_number": "856-875-9550",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2055 Briggs Rd",
"address_purpose": "LOCATION",
"city": "Mount Laurel",
"state": "NJ",
"postal_code": "080544630",
"country_code": "US",
"telephone_number": "856-875-9550",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANNUZZI",
"first_name": "MARY -KAY",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2021-09-08",
"certification_date": "2021-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "DI 02215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sicklerville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.